This section provides background information related to the present disclosure which is not necessarily prior art. This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features.
Distraction enterogenesis (DE) may provide a novel therapy for short bowel syndrome (SBS). Previously described methods have relied upon isolated intestinal segments or transmural fixation due to ineffective endoluminal attachment. The present teachings provide a novel approach using geometric coupling between a tapering device and the mesenteric curvature to allow trans-stomal distraction enterogenesis.
A catheter device with tapering stiffness was developed, consisting of, in some embodiments, a stiff catheter with a taper to a flexible latex tip to prevent perforation. Yorkshire pigs underwent creation of a jejunal Roux limb with device placed via jejunostomy. Intestinal attachment was achieved without substantial reduction in bowel perfusion as measured by laser Doppler. An external clamp was secured at the stoma to provide external fixation of the device. The catheter was advanced 1 cm/day for either 7 or 14 days before explant.
After 7 days, the distracted segment achieved a mean±SD increase in length of 37±6% versus fed, nondistracted bowel, corresponding to an absolute gain of 10.6±1.7 cm (1.5 cm/day). After 14 days, the Roux limb achieved an 80±2% increase in length versus fed control bowel, corresponding to an absolute gain of 16.8±3.0 cm (1.2 cm/day). No perforation or stoma-related complication occurred.
More generally, the principles of the present teachings provide an indwelling device for insertion in a biological tubular structure comprising an elongated device having a body and opposing ends. The body has a bending stiffness transverse to a longitudinal axis that is greater than a stiffness of the biological tubular structure. An atraumatic tip member, having a proximal end and a distal end, extends from the end of the elongated device. The proximal end has a first bending stiffness transverse to a longitudinal axis and the distal end has a second bending stiffness transverse to the longitudinal axis, wherein the second bending stiffness being less than the first bending stiffness.
Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.
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